Labor Repose

Labor Repose
LaborPayne during her 6th homebirth (9th baby) at age 44

Sunday, May 31, 2009

Charmed Living

Just finished reading Victoria Moran's book, "Living a Charmed Life". Loved this book, just as I loved it's predecessor "Creating a Charmed Life." It's all about becoming who we are through conscious being and doing. It's chock full of juicy little tidbits and practical application for living a life of excellence and relevance. I highly recommend it. It's written in a series of little 1 1/2 page essays so you can easily read an essay a day. I read mine with a cup of hot tea in my garden every morning. With the sun rising in the sky, and a cat on my lap, and the tinkle of chimes in my ear, and my orange spice candle perfuming the fresh air, I find it is the perfect start to every day. (Notice I like to involve all my senses in my daily quiet time). Over the next few weeks, I'll be writing about lessons learned and experiments tried from the book. Come along for the ride, or get the book and create your own adventures!

Tuesday, May 19, 2009

End of an Era

Yesterday I attended my final board meeting for the healthcare foundation to which I had belonged. It was bittersweet. I look forward to moving on to other board work, like the Health Commission, but I also will miss the terrific folks I worked with at the foundation. I was a great 3 years. I learned so much. Sadly I feel like I gained more than I actually gave. I am proud of the way the foundation is leaving its legacy in the health and wellbeing of citizens on both sides of the state line. I was visiting a school a few weeks ago to find potential clinical sites for my nursing students, and the administrator mentioned the dental screenings all the kids would be getting from this new program... I had to smile inwardly because I knew that program was funded by the foundation. It's good work abounds and reverberates throughout the bi-state area and the impact of it will be felt for (hopefully) generations to come.

Monday, May 18, 2009

Batman Update

Josiah Thomas... that is. He's now a strapping 2 1/2 years old and goes by the name Batman. Yes, that's right- he's smack dab in the middle of a Batman obsession (cape and all). He's completely fixated on a cartoon series called, "Teen Titans." Keeping up my facade of good parenting won't allow me to tell you how many hours a day he watches it. He has a toy Batman that he carries around, and owns 3 shirts with the image of Batman on them. We can only remove one from his body to wash, if we have another to replace it. However, lately he's taken to wearing two at a time... Josiah is adding new words to his vocabulary everday. He happily eats whatever is in front of him, isn't even thinking about potty training, and is a happy healthy child. He's not to shabby with water gun and plastic sword either. Ahh the sweet simplicities of toddler life...

Thursday, May 14, 2009

I Support Perineums

I have been talking with a colleague about birth position. She has recently become very irritated about women being forced to give birth on their backs. I'm afraid her irritation was precipitated by a discussion we had about my homebirth, a couple of years ago. I told her why I choose not to give birth in a bed, and prefer instead a standing supported squat. (I also gave birth on all fours once and another side-lying.) Since my friend is planning a second pregnancy in the near future, she has been examining these issues closely. "Why do we submit to that?" she demanded to know. I suspect its mostly because we don't know any better. We assume that all the things we are asked to do is for our safety or our baby's safety (and a lot of the time that is true). However, this one is purely for the careprovider. I haven't seen any research on it, but my hypothesis is that we put our perineums in jeapordy with the lithotomy position. It gives physicians and nurses lots of nice access, but mainly for the purpose of casually abusing the tissue. It is my ethical stand that healthy muscle or tissue integrity should not be compromised (ie. cut or severed) without medical provocation. The muscles and tissue of the perineum are made to stretch to accomodate the birth of a baby. Yes, there are times when tissue manipulation is warranted, but mostly lying down to give birth makes as much sense as lying down to have a bowel movement.

Wednesday, May 13, 2009

Circ Alert

I read this on Sarah the Doulas blog:

"Although I skip it as often as I watch it (because sometimes the cesareans and procedures are just too maddening), on "A Baby Story" yesterday, these exact words came out of the mouth of a man about to do a circumcision on a newborn:"Up to six months he didn't develop any nerve endings. He has no pain. So I don't want you to really think "Why, he's crying because he's in pain."My jaw dropped. And not in a good way."

Wow! I can't believe somebody out there is still pulling the old 'babies don't feel pain' crap. In my last class of RN students- we went round and round on the circumcision issue. The students actually had some very dynamic dialog on the issue. I always show a video of an actual circ before we get into our discussion on it-but some students saw some in clincals at the hospital first. Boy were they shocked! Here are some exerpts from their online discussion about it:

"Today I was on the labor and delivery floor. There wasn't much action so I hung out and waited for any procedure or experience. I did get to see a circumcision. I always believed that circumcision was important for every boy. I thought he might embarassed or made fun of if he was different than other boys. I knew there was no mandatory medical reason for a circumcision but never questioned the practice. After seeing the procedure done today I am torn about the practice. How is this any different than the genital mutilation we hear about in other countries? I know in other countries it is done to woman and to prevent pleasure but both are done for cultural reasons. I couldn't help but think that in the future the instruments used in this procedure would be in a museum and people would be horrified by the practice that we see as normal and "mandatory"."

Followed by:

"Actually my friends, I believe they have proven the circumcision helps to prevent infections...including STI's and UTI's. As most of us have worked in LTC, we have come across an uncircumcised male and have seen how staff do not pull back that foreskin to wash...YUCK! I know it looks barbaric when you watch it done on an infant, but I always thought, well, better now then when he is older! are right. It is, and probably will always be a controversial issue."

Another student weighed in with:

"On the American Academy of Peds website a recent survey showed that only 34% of dr in the survey thought the benefits outweighed the risks. I think circumcision is different than mutilation in other countries because in the other countries this is done to women to remove sexual plessure. The procedure has no medical indication"

Another countered with:

"I understand that it can reduce the incidence of infection however, this does not make it mandatory. If we could reduce the amounts of yeast infections in women by removing some of their genitalia would we all agree to that practice?"

Our only male student in the class concluded this:

"Being the only guy in class, I decided it would be most appropriate to comment on a circumcision. Lol. Actually, I witnessed this disgusting act of brutality on the baby boy as well. I could only stand to the side and watch in horror. I thought I knew what they did for a circumcision, but I didn't know to the full extent of what actually takes place.With that being said, I'm absolutely glad my mother/father signed that consent form. I wouldn't want it any other way. When/If I ever have kids, more specifically a boy, I would want him to be circumcised, even knowing what he will have to go through."

The conversation went on over several weeks actually. I was so proud of the students for really grappling with this issue and having an honest discussion about it. In the end some students maintained that they would still circumcize their male children while others were adamant that they would not. My proudest moment came in knowing whatever they concluded, from this point on they would all have a better understanding of the hows and whys of the procedure and not just a knee-jerk socio-culturally-based position.

Tuesday, May 12, 2009

Come, Grasshopper...

Life has whisked me away, but writing once again draws me back. I just completed another class of OB students and am planning for the summer class. It is my challenge to present OB nursing in a wholistic, humane way, since the reality of my chosen profession seems anything but. How do I teach the rigors of nursing care for the childbearing family and at the same time not approach this as 'business as usual'. Having a baby is not the same as having your gallbladder removed. It should be a spiritual, family-centered event designed to welcome the newborn in a respectuful, humane way. The things I teach are a direct contradiction to what they see in the hospital when they go for clinicals. The students are smart. They are quick to pick up on the inconsistances and I watch as they struggle with questions it all provokes. The best learning is in this struggling. It is in these struggles that they find that cognition and psychomotor skills come easily- but values, attitutes and beliefs- these are harder won. Yet these nontangibles will shape them more as nurses than knowing how to hang and IV bag or read a monitor strip. It is my constant challenge as an instructor to impart nursing as a noble profession, and yet constantly examine the devil that is in the details.